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This is the way we Blitz

Yo.
I've been doing allright with blitz lately. I think he is hella fun and when I am concentrating well enough to use rocketgrab correctly (I have a tendency to /fail at aiming) I kick ass.
Here is the build I use most often

Items-
Health gem on my way to Leviathon
Basic boots on my way to +3 move
Mana gem on my way to Tear of the Goddess
Vampiric Scepter to get Malady

Next depends on my team and the enemy, I like-
Long Sword on my way to Last Whisper
as well as
BF Sword on my way to Black Clever

if the game goes long I ditch ToG for more attack and speed weapons.
I've tried Nashor's tooth for cooldown reduction but it wasn't that hot. Brutalizer doesn't have enough going for it outside of CD imo.

Strategy-
if I like my partner (I never solo) I get rocket grab for early ganks, otherwise I get punch, RG, accelerate (I'm terrible at the names you know what I mean).

I use flash and heal, it's an awesome combo whether I need to run next to a tower to finish a kill, heal while doing so and flash out, or just to keep my ass alive.

Early game my items are about survivability, after level 6 (when I get leviathon) I start trying to live and get stacks... I help mid gank his op, move to other side for a quick kill, then back to my own lane to jump on whoever my partner has been messing up. If my teammates aren't morons and my aim isn't ****ty I have ~5 stacks of leviathon by level 8 which is a huge help in the mid game, and I keep farming on my way to end game.

Health Gem as a starting item is a poor choice because it leaves you no money for potions. Starting potions are handy because if you get hit hard at the beginning by the opposing team lurking in the bushes or etc, you don't have to go back right away. It also gives you more resiliency against harassment.

Leviathan is highly questionable. As a Tank/Initiator, you're often going to die and probably not frequently going to be getting the last hit on champs.

Tear of the Goddess? To what end? If you're really having mana problems, try something like Chalice (starting of Meki + 2 Pots into a Chalice is a good way to begin), which gives you all the mana you'd need plus some handy MR.

Malady is an item that's only really good on a few champions: Warwick, because he hits them in rapid succession, really stacking the damage, and Twitch, because he can spray and pray it over their entire team. For Blitz, you're MUCH better off going Bloodthirster or Stark's, Stark's helps your team (and has nearly as much Attack speed and 5% more lifesteal than Malady) significantly, while Bloodthirster increases your burst damage. And let's face it, your job is to Grab -> Power Fist -> Static Field for a burst damage kill, not to try and attack someone for several straight seconds in an attempt to DPS them down.

Last Whisper is a great item, but it is terrible with Black Cleaver, as the cleaver's reduction applies first, weakening the Whisper's Penetration.

If you really want to go high-damage Blitz, I would suggest starting off by building Sheen, then build it into Trinity Force. This will massively increase your Power Fist damage, as well as giving you all kinds of useful stats. After that, standard DPS fare (Infinity Edge, Last Whisper, Starks/Bloodthirster) round you out.